Category Archives: Uncategorized

Dying in Long Term Care Facility (LTC) Issues

Some LTC facilities are reluctant to be involved in end stage care as they already have a reputation as the place the old go to die. Those that embrace it, require more staff, as the dying have rights to increased … Continue reading

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Reasons Why Vit D Helps Chronic Pain Coming Clearer – Vit D Genes

A Fokl DNA gene polymorphism in the Vitamin D receptor would reduce its sensitivity to vitamin D. Vitamin D supports many metabolic processes beyond calcium and gene variations are even associated with certain cancers.  In athletes, the FF Fokl genotype … Continue reading

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Simulating Ketamine Infusions with Repeated Deltoid Muscle Injections

Protocol from Anodyne Headache and Pain Care in Texas gave 0.3 mg – 0.4 mg/kg ketamine divided into 3 deltoid IM shots separated by 15 minutes for headache and neuropathic pain.  A remarkably successful ketamine IV treatment for depression gave … Continue reading

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Shooting Trigeminal Neuralgia – Facial Epicrania Fugax – and a New Treatment

6-8 years ago a brief neuralgic pain in the scalp that radiated to front or back of head was described. I wrote about it here: Now a facially originated version has been defined and sounds very much like trigeminal … Continue reading

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I Stand Corrected- CT Do Help Problems – Alzheimer’s and Asthma Treatment -and Radiation Could be Good

Some specialists will leave patients in abject pain with the implication that the imaging they have ordered will in some way help their pain. It does not.  However, an Alzheimer victim was subjected to 4 head CT and has made … Continue reading

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Pregnancy Gone Badly – needs Quick Diagnosis and Treatment

Came across this while searching pain. It is so deadly, I had to write it up. Catastrophic antiphospholipid syndrome (CAPS) is a rarely occurring condition leading to death in up to to 1/3 of cases. It can be confused with … Continue reading

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Chronic Headache Tragically Missed Cause – Intracranial Hypotension – And Poor Imaging Issues

New cases series of patient twith chronic headache that oft went thru a litany of doctors without success with a clearly treatable disease. Each gave a history of  headache on arising and relieved by lying down that was discounted because … Continue reading

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Predicting Response to SSRI Antidepressants (Not SNRI’s though)

Less than 30% patients respond to antidepressants. Study cataloged depression scale and other features and came up with predictors of depression response particularly to Escitalopram. They included Demographics like black, unemployed, and uneducated; Depression severity and persistence all day ; … Continue reading

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Could Marijuana Help Headaches?

With Medical Marijuana,  migraine frequency dropped from 10.4 to 4.6 headaches per month.

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Arthritis /NSAID Allergy – Want Can You Take?

Odd as it sound people allergic to aspirin and arthritis pills can tolerate Sodium salicylate and is non- acetylated. Pharmacy College assures me it is still available as Dodd’s sodium salicylate which is still available through pharmacy suppliers so pharmacy … Continue reading

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Nocturnal Rib Impingement

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More Painful Bladder Syndrome Non-invasive Treatments

I have painful bladder victims that do not want instillations – multiple allergies that would make infections impossible to treat is one issue. There are some other options mentioned in a recent review that are not common.

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Benign Positional Vertigo? – Modified Canalith Repositioning Maneuver (CRP)

Effectiveness of Treatments for Benign Paroxysmal Positional Vertigo of the Posterior Canal Helen S. Cohen, Kay T. Kimball Otol Neurotol  26: 1034–1040, 2005 Modified  Canalith  Repositioning  Maneuver  (CRP)  technique: The head was held in each position as follows: The subject … Continue reading

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Multiple Sclerosis (MS) Help – Biotin (Vitamin B7) High Dose – and What More Could You Take?

In MS cases, 1/6 noted clinical improvement over 2-8 months with Biotin 300 mg/day This is exciting not just for the improved people but potentially for a group that might not further deteriorate. Suggestion was to take 100-300 mg/day which … Continue reading

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Pseudofolliculitis cutis – ingrowing facial hair Treatments

Ok this is not a pain  condition but I wanted to put advice where patients can find it.

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Headache Just At Night – Try Indomethacin

Hyponic (night only) solely headaches are uncommon. In some ways they are distinct from migraines as the drug of choice is Indomethacin 50 mg twice daily.

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Chronic Scrotal Pain Algorithm

Chronic scrotal pain can be an enigma – this new article gives detailed options for investigation and treatment. I have spent a great deal of time trying to give a clear view for people –  let me know if you … Continue reading

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Pain and Depression – Consider Brain Inflammation With Tumor Necrosis Factor (TNF) – and What About Brain Aging

  Prior, I published a belief that depression in some cases was a manifestation of chronic pain for which ketamine could temporarily block. In this 21 page article they make clear connections between brain cytokine inflammation especially TNF (Tumor Necrosis … Continue reading

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Vulvodynia in Young Can Be Helped by Treating Hip

6/7 women aged 20-29 with vulvodynia and hip pain experienced significant relief by having therapeutic arthroscopy for hip femeroacetabular syndrome. None of the 19 older cases sustained any benefit.

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New Treatment for Scabies – and even bad Rosacea, Blepharitis, and Scalp Folliculitis

Scabies has become increasingly resistant to Nix and Kwelleda leaving people with attempts to get Ivermectin orally by emergency release from the US (not easy – they kept sending me repeated letters with more questions to answer). It is easy … Continue reading

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Are You Sick of Health Web Sites?

I am sick of health websites that: – don’t give links to what they discuss – are filled with commercial ads – make you go though multiple pages, each with various ads – just repeat what you see elsewhere. It … Continue reading

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Autosomal Dominant Polycystic kidneys – avoid or keep Estrogens to low dose

Recent review of Polycystic Kidneys states “Because of the proliferative effect of estrogen on hepatic cysts, oral contraceptives containing estrogen and menopausal estrogen therapy should be administered at the lowest effective dose or avoided in patients with ADPKD (autosomal dominant … Continue reading

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Serum Lipase Should Be Test For Pancreatitis

Serum lipase has a sensitivity of 91% while amylase had sensitivity of 61%. Specificity was 92% for lipase and 93% for amylase.  Testing lipase and amylase together changed sensitivity very little – was 93%.

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Bell’s Palsy Treatment Algorithm

Latest algorithm suggests you make sure of diagnosis Use of antivirals doesn’t work Prednisone 1 mg/k x 7 days (why does one need to taper though?) useful

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Drugs for Diabetic Neuropathy

 Should we believe these results?  A study on treatment for diabetic neuropathy pretends one treatment is better than onother because on group starts with more severe pain than the other then claims each treatment can virtually eliminate pains with 7 … Continue reading

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